Search PubMed⌕ Search

Biomedical subjects

J R Green

Publications and source records attributed to J R Green.

At least 91 records · Page 5Linked to original sources
PubMed1991

Peripartum cocaine use: estimating risk of adverse pregnancy outcome.

Pregnancy outcome of 83 patients with a positive urine toxicology screen for cocaine in the third trimester were reviewed. The outcomes of pregnancies complicated by cocaine abuse were compared to those of matched controls selected from our general obstetric population. We observed a statistically significant increase in the incidence of premature separation of the placenta, low birthweight infants, preterm deliveries, and the incidence of fetal distress requiring cesarean section. On admission, 55% of patients denied recent cocaine use. These observations have implications for planning perinatal services.

Abruptio Placentae↗
PubMed1991

Reducing disinfectant wastage.

In order to lower departmental costs in an ophthalmological outpatient department by reducing wastage, the stability of available chlorine at levels of 280 ppm and 560 ppm in litre solutions of sodium dichloroisocyanurate was investigated over a three-week period. There was no significant decay in available chlorine at these levels in solutions kept at 20 degrees C. Sodium dichloroisocyanurate may be prepared on a weekly instead of a daily basis with an annual saving of 1200 pounds to 1400 pounds.

Chlorine↗
PubMed1991

Fibroepithelial polyps of the vagina in pregnancy.

A 38-year old pregnant woman presented with a polypoid tumor of the vagina. A biopsy revealed benign fibroepithelial polyps. Her pregnancy progressed normally, and she underwent an uncomplicated vaginal delivery. Once the benign nature of the lesion has been established, a spontaneous vaginal delivery is not contraindicated. However, operative vaginal delivery should be avoided to reduce the risk of trauma and hemorrhage. Local excision is curative and may be performed as an interval procedure when the vaginal vascularity has returned to normal.

Adult↗
PubMed1991

Ig CH and D14S1 variants in rheumatoid arthritis--linkage and association studies.

We have looked for an effect of 14th chromosomal genes linked to immunoglobulin heavy chain (IgCH) or D14S1 regions on susceptibility to rheumatoid arthritis (RA) by both linkage (sibling pair analysis) and association studies. There was no overall linkage between RA and either IgCH or D14S1. However, Gm haplotype similarity in affected siblings appeared greater in either DR4-positive as compared to DR4-negative sibships or in sibships without clinical or serological evidence of autoimmune thyroid disease when compared to sibships with such evidence. In association studies there were no associations at the D14S1 locus. Within the Ig CH region there were no overall associations. However, within the RA population G1m (z) and G3m (g) both appeared less frequent in DR4-negative RA versus both DR4-positive RA and versus control groups. Analysis of DNA variants at Ig CH loci showed differences at the gamma 4 locus with a 9.0 kb fragment appearing less frequently in DR4-positive RA versus DR4-negative RA and control groups. The results suggest a weak or HLA-DR dependent effect of genes linked to the Ig CH region on susceptibility to RA.

Arthritis, Rheumatoid↗
PubMed1991

Testing for haplotype sharing by siblings with incomplete information of parental haplotypes.

Testing for the inheritance of a disease susceptibility gene by analysis of haplotype sharing among affected siblings has been well established for the case where all four parental haplotypes have been ascertained. This paper presents a modification of a published method to cover the situation where there is incomplete information concerning parental haplotypes and this new test is applied in a worked example.

Female↗
PubMed1991

Randomized, double-blind trial of deflazacort versus prednisone in juvenile chronic (or rheumatoid) arthritis: a relatively bone-sparing effect of deflazacort.

Thirty-four children with juvenile chronic (rheumatoid) arthritis were recruited to a randomized, double-blind study of deflazacort (an oxazolone derivative of prednisone) vs prednisone. All had been receiving glucocorticoid therapy for at least 1 year and required at least 5 mg/d of prednisolone (usually as 10 mg every 2 days). Thirty-one children completed the study. Bone density trends were measured in the spine by dual photon absorptiometry and in the forearm by single photon quantitative computed tomography at 3-monthly intervals. Trends (velocities) in bone and soft tissue growth were calculated. In the spine, bone growth correlated well with indices of soft tissue growth, but covariance analysis showed a significant advantage (P less than .007) of deflazacort when spinal bone mineral growth was compared to body surface area and weight. In part this was due to a temporary interruption in weight by children receiving deflazacort, whose gain in height was comparable with that of the prednisone group. Some children in both groups improved clinically and showed catch-up growth; in these children relative spinal bone mineral growth velocities were about twice those observed for height and weight. It is concluded that during the first year of deflazacort, their spinal bone mineral content at a level that was appropriate for their height and weight. Further observations are required to establish whether this advantage can be maintained subsequently. The anti-inflammatory effects of the two glucocorticoids appeared similar.

Adolescent↗
PubMed1991

Influence of maternal body habitus and glucose tolerance on birth weight.

Many physicians believe that macrosomia is a hallmark of a pregnancy complicated by glucose intolerance. Because the prevalence of obesity is increased among women with gestational diabetes, fetal overgrowth may be attributable at least in part to maternal obesity. We studied 2069 black, Latina, Chinese, and white mother-infant pairs to determine the interaction between maternal body habitus, maternal glucose homeostasis, and certain indices of fetal growth. Chinese women had a significantly higher serum glucose 1 hour after administration of 50 g glucose (136.6 +/- 32.7 mg/dL) than any of the other three ethnic groups. Black women had a significantly lower value for glucose (114.8 +/- 28.2 mg/dL) than either Chinese or Latina women (124.9 +/- 31.4 mg/dL). Results for Latina and white women (121.5 +/- 26.2 mg/dL) were not significantly different. Body mass index (BMI) was used to classify the subjects. The regression coefficient for the entire sample indicated a modest association of glucose with increased birth weight when maternal BMI was controlled. The BMI of the Chinese infants had a significant association with higher concentrations of glucose after administration of 50 g glucose. Maternal body habitus should be considered a major confounder in studies of the relationship of maternal glucose tolerance and infant birth weight.

Birth Weight↗
PubMed1990

Omeprazole provides quicker symptom relief and duodenal ulcer healing than ranitidine.

In a double-blind, parallel-group clinical trial in 248 patients with symptomatic duodenal ulcers [97% greater than 5 mm diameter], 126 were randomized to receive omeprazole 20 mg once daily in the morning and 122 were randomized to receive ranitidine 300 mg once daily at night for 2 wk and if the ulcers were unhealed for a total of 4 wk. When ulcer healing was assessed on an intention-to-treat basis, 79% of those receiving omeprazole had healed ulcers after 2 wk compared with 62% of those receiving ranitidine (p less than 0.005; therapeutic gain for omeprazole, 18%; 95% confidence intervals, +6% to +29%). At 4 wk the figures were 91% (omeprazole) and 80% (ranitidine) (p less than 0.05). After 2 wk, 77% of omeprazole-treated and 59% of ranitidine-treated patients were free of ulcer pain (p = 0.005). Assessed by diary cards (successfully completed by 92% of patients), daytime pain resolved more quickly in omeprazole-treated patients than in those receiving ranitidine (p less than 0.01). Omeprazole-treated patients took fewer antacids (p less than 0.05) over the first 2 wk. Omeprazole, 20 mg each morning, provides more rapid relief of the symptoms of duodenal ulcer and heals a greater proportion of duodenal ulcers within 2 and 4 wk than ranitidine, 300 mg each night.

Adult↗
PubMed1990

High indices of remodelling in iliac trabecular bone predict reduced forearm cortical bone mass indices in patients with proximal femoral fractures.

To investigate whether high bone turnover could be a predictor of cortical bone loss and a candidate risk factor for fractures of the proximal femur, 33 7.5-mm transiliac biopsies taken at fracture fixation from 48 patients who participated in a study of potential risk factors have been quantitated. Twenty-four of the 33 patients made good recoveries and about 6 weeks postoperatively consented to bone densitometry of the forearm midshaft. Forearm bone density correlated negatively (r = 0.77, P = 0.001) with the surface of trabecular bone covered with osteoid, which in osteoporotic patients with crush fractures of the vertebrae was previously shown to relate both to rates of bone formation and resorption. An important minority of these femoral fracture patients appeared to be suffering from high rates of iliac trabecular bone resorption. Thus, high bone remodelling activity could lead to excessive cortical thinning. This has pathogenetic implications which may be clinically important.

Aged↗
PubMed1990

Glucose tolerance in pregnancy: ethnic variation and influence of body habitus.

Little is known about ethnic differences in glucose tolerance during pregnancy. In this study we examined 3366 Hispanic, Chinese, black, and non-Hispanic white women in a universal screening program for gestational diabetes mellitus. After maternal age and body mass index were controlled, Chinese women had a significantly higher serum glucose level 1 hour after 50 gm of oral glucose (134.8 +/- 1.2, mean +/- SE) than any of the remaining three groups. Black women had a significantly lower value (113.3 +/- 1.3, mean +/- SE) than either Chinese or Hispanic women (124.4 +/- 0.9, mean +/- SE). Results for Hispanic women and non-Hispanic white women (121.4 +/- 1.6, mean +/- SE) were not different. The screening glucose levels of Chinese women were substantially higher than other ethnic groups even when women with gestational diabetes were removed from the analysis, indicating that the observed differences were not solely due to a higher frequency of gestational diabetes among the Chinese. The incidence of gestational diabetes was significantly greater for Chinese (7.3%) and Hispanic (4.2%) women than for black (1.7%) and non-Hispanic white (1.6%) women. Among women who had a 3-hour glucose tolerance test, the area under the glucose curve was significantly associated with maternal age and body mass index. The demonstrated heterogeneity of glucose tolerance between ethnic groups may be of importance in determining the threshold for diabetic fetopathy, and it is possible that ethnicity-specific standards will need to be developed.

Asian People↗
PubMed1990

Mucosal peptide hydrolase and brush-border marker enzyme activities in three regions of the small intestine of rats with experimental uraemia.

1. The activities of nine peptide hydrolases and three non-peptidase brush-border marker enzymes have been quantified in crude homogenates prepared from the proximal, mild and distal regions of small-intestinal mucosa for sham-operated (n = 9) and uraemic (n = 14) rats. Abnormalities in enzyme activities were observed in all regions studied in the uraemic group, although no reduction in food intake occurred. 2. The proximal region of the small intestine from uraemic rats showed a general fall in enzyme activities associated with the brush-border. This fall was combined with a decline in mucosal protein content. In contrast, the mid and distal regions showed increased activity against the dipeptide tyrosyl-glycine. 3. It is proposed that the fall in brush-border enzyme activities in the proximal small intestine of uraemic rats is a response to the increased water intake associated with this, and presumably other, rat models of uraemia. The increased enzyme activity against tyrosyl-glycine found in the mid and distal regions of the small intestine of uraemic rats may be caused by an increased small-intestinal transit rate, but could be an attempt to maximize tyrosine absorption in response to decreased plasma tyrosine levels. 4. This study casts doubt on specific activities being the most useful units of enzyme activity, when measured in crude homogenates prepared from the proximal small intestine of uraemic rats. It also demonstrates that enzyme activities measured at a single site in the small intestine of uraemic rats may not be representative of the enzymatic changes occurring in the small-intestinal mucosa as a whole.

Animals↗
PubMed1990

An outbreak of suspected Phalaris staggers in sheep in the western Cape Province.

An outbreak of suspected Phalaris staggers in South Africa is described. Approximately 40 out of 600 sheep that had been grazing for 3 weeks on a wheat stubble land heavily infested with Phalaris grass, were affected. Clinical signs included nervous tremors, ataxia and convulsions. New cases occurred even after removal from the affected pasture. The most prominent microscopic lesion seen in the 2 sheep autopsied, was an accumulation of intracytoplasmic brown pigment in the neurons of the brain.

Animals↗
PubMed1989

The prism bar--Prentice and frontal positions.

The prism cover test has been in use for many years for measuring ocular alignment. The measurements obtained are used for both calculating the amount of correction needed in strabismus surgery, and monitoring any change in ocular alignment with recovery from muscle imbalance. Variability may arise from its use in either the frontal position or the Prentice position. Most prism bars used in the United Kingdom are calibrated for use in the Prentice position. Inaccurate results arise when a prism bar is used in a position for which it is not calibrated. The theoretical calculation for adjusting measurements obtained in the frontal position with prisms calibrated for use in the Prentice position was assessed clinically. A new modified equation is proposed incorporating practical aspects of performing the prism cover test. A table of values is included to assist in determining the necessary adjustment, so allowing for a more reliable assessment.

Adolescent↗
PubMed1989

Prophylaxis in caesarean section with cefmetazole and cefoxitin.

A prospective, randomized, open comparison of three 1 g doses of cefmetazole with three 2 g doses of cefoxitin for non-elective Caesarean section was performed. Sixty-nine patients were evaluated. The two groups were comparable with respect to labour characteristics that might influence risk of postoperative infectious morbidity. Similarly, the nature of the bacterial contamination/infection of the amniotic fluid at the time of Caesarean section was comparable in the two groups. The only infectious morbidity noted was endomyometritis. The incidence was the same in both groups, 5/50 (10%) in the cefmetazole group and 2/19 (10.5%) in the cefoxitin group. Febrile morbidity, as reflected in the fever index, was not significantly different between the groups, 10.2 +/- 18.5 degree hours in the cefmetazole group and 7.5 +/- 11.7 degree hours in the cefoxitin group. Cefmetazole appeared to be equivalent to cefoxitin in reducing post-Caesarean section endomyometritis.

Adolescent↗
PubMed1989

Use of ranitidine in children undergoing cardiopulmonary bypass.

Sixty children aged 6 wk to 10 yr were studied. The children were undergoing cardiopulmonary bypass (CPB) for correction of congenital heart defects. The aim of the study was to provide prophylaxis for stress-induced gastric ulceration by elevating the gastric pH to at least 3.5. Two infusion regimes of ranitidine were compared: 0.1 and 0.2 mg/kg.h. The period of study was from induction of anesthesia until the end of the first 24 h after surgery. Both regimes were effective. The 0.2-mg/kg.h infusion produced a significantly higher plasma concentration of ranitidine throughout the study period without any additional clinical benefit. Both regimes produced, within 3 h of cessation of CPB, a significant elevation in mean gastric pH to at least 5.3. This paper concludes that 0.1-mg/kg.h infusion of ranitidine is a safe and efficacious regime for the critically ill pediatric patient.

Cardiopulmonary Bypass↗
PubMed1989

Isolated lichen planus of the nails associated with primary biliary cirrhosis.

Lichen planus is a relatively common inflammatory dermatosis with characteristic lesions affecting the skin, nails and mucous membranes. Nail changes are present in approximately 10% of patients and can occasionally occur in the absence of skin involvement. The association of lichen planus with primary biliary cirrhosis is now well recognized. We report the first case of lichen planus confined to the nails in a patient with primary biliary cirrhosis.

Female↗