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Biomedical subjects

J Smith

Publications and source records attributed to J Smith.

At least 721 records · Page 40Linked to original sources
PubMed1993

Sequence analysis of the gp120 region of the env gene of Ugandan human immunodeficiency proviruses from a single individual.

DNA sequences encoding the surface glycoprotein gp120 of the human immunodeficiency virus type 1 (HIV-1) were amplified by the polymerase chain reaction (PCR) from peripheral blood mononuclear cells obtained from a Ugandan AIDS patient. The PCR-amplified DNA was cloned into a phagemid vector and nine clones sequenced. The gp120 sequences of the proviruses were similar to that of the Zairian isolate HIV-JY1 and unlike that of another Ugandan provirus, U455. Six of the clones were closely related to each other (maximum nucleotide sequence divergence 1.9%), and had a V3 amino acid sequence similar to that frequently seen in recent isolates from Uganda. Two others formed a second group that diverged from the first by an average of 6.0% at the nucleotide level, resulting in a 12.5% divergence of amino acid sequence. These divergent clones had extensive amino acid sequence changes not only in the V3 region, which was highly atypical, but also in V1 and V4, and to a lesser extent in V2 and V5. A further proviral clone had a sequence intermediate between those of the other two groups of clones.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Medical students' clinical self-assessments: comparisons with external measures of performance and the students' self-assessments of overall performance and effort.

PURPOSE: To find predictors of students' initial self-assessments of their clinical performances, the predictive value of their self-assessments, and factors that relate to their final self-assessments. METHOD: Of the 142 third-year students at the University of Michigan Hospital in 1988-89, 137 (96%) completed a self-assessment questionnaire on the first day of their internal medicine clerkship and a slightly expanded questionnaire on the last day. The questionnaires asked the students to use Likert-type scales to rate their abilities regarding clinical skills, use of knowledge in the clinical setting, and discharge of patient care responsibilities. Also collected were data on the students' performances as measured externally: college grade-point averages; standardized examinations taken before, during, and after the clerkship; and ratings given the students by the faculty and residents with whom they worked in the clerkship. Pearson product-moment correlations were then calculated between the students' self-assessment ratings and their scores on the external measures of performance. RESULTS: Weak to absent correlations were found between prior-performance measures and initial self-assessments. The lower-performing students, as measured by college grade-point averages and Medical College Admission Test scores, tended to rate their performances higher than did their peers at initial self-assessment. IN contrast, the higher-performing students rated themselves lower than would be warranted given their prior performances. There were significant increases in the initial self-assessments as the year progressed and the students entered the clerkship after having had more experience. The correlations between the students' final self-assessments and the ratings by faculty and residents were generally weak. The strongest (.267, p < or = .001) concerned the students' medical knowledge. In addition, there was a moderate correlation (.413, p < or = .001) between the students' self-assessments of how hard they had worked and their self-assessments of overall performance. CONCLUSION: The findings in this study were similar to those of previous studies in that they showed relatively poor agreement between external measures of students' performances and students' self-assessments of their performances.

Clinical Clerkship↗
PubMed1993

QUDOS: a quality assurance system for health care.

Describes a system of quality assurance for use by either purchasers or providers of health care services. The system has been in operation since 1991 and is compatible with registration to BS 5750.

Consumer Behavior↗
PubMed1993

Ultraviolet sterilisation of model viruses important to finfish aquaculture in Australia.

Mortalities approaching 100% have been recorded in larval barramundi and cultured rainbow trout. These have been attributed to a picorna-like virus and an iridovirus, respectively. Two Australian-made ultraviolet sterilising units were tested for their effectiveness in inactivating water-suspended model viruses. These were an iridovirus isolated from frogs and a picornavirus, bovine enterovirus, both of similar structure and size to the pathogenic fish viruses. Both viruses were inactivated by both ultraviolet units at a flow rate comparable to that used in nurseries in aquaculture (5000 L/h). With transmittance reduced to 27.7%, the minimum effective dose was 2.6 x 10(4) uW.sec/cm2 for both viruses.

Agriculture↗
PubMed1993

Creatinine related reference ranges for urinary homovanillic acid and vanillylmandelic acid at 6 months of age.

The relationship between homovanillic acid (HVA), vanillylmandelic acid (VMA), and creatinine in the urine of 6 month old babies has been studied and reference ranges in the form of centiles constructed for HVA and VMA against creatinine. Over 10,000 urine samples were collected from babies in four health districts in the north of England. HVA and VMA concentration, either independently or when divided by creatinine concentration, were dependent upon the absolute concentration of creatinine in the sample. After adjustment for creatinine significant differences in the mean concentration of HVA were found between sexes. No such differences were found for VMA. HVA and VMA were also found to be age dependent. Centiles were constructed using a procedure which makes no distributional assumptions about the data. The net effect of utilising these centiles was to increase the predictive value of a positive screening test from 20% to 40% without any increase in the false negative rate.

Creatinine↗
PubMed1993

Lithium toxicity.

Explore the source record for details and available documents.

Bipolar Disorder↗
PubMed1993

Suicide among forensic psychiatric patients.

This paper examines the problem of suicide among patients discharged from a Regional Secure Unit. The stereotype that emerges is a young man with anti-social personality traits, suffering from an affective psychosis, with a history of substance abuse and impulsive violence directed both towards himself and others, who is alienated from care staff and social supports because of his provocative and uncooperative behaviour. In contrast with the general population, forensic patients are more likely to commit suicide using a violent method and are more likely to have a suicide verdict recorded by the coroner. The implications of these findings for treatment and preventive interventions are discussed.

Adult↗
PubMed1993

American Orthopaedic Foot and Ankle Society women's shoe survey.

Shoes have been implicated as being responsible for the majority of foot deformities and problems that physicians encounter in women. A total of 356 women were studied in this investigation to evaluate trends in women's shoe wear and their effect on the development of foot deformities and pain. The majority of women in this study wore shoes that were too small for their feet, had foot pain and deformity, and had increased shoe size since the age of 20. Few women had their feet measured in over 5 years. The women without foot pain or deformities also wore shoes that were smaller than their feet but to a lesser degree.

Adult↗
PubMed1993

Childhood sexual experiences with adults. A comparison of reports by women psychiatric patients and general-practice attenders.

Reports of childhood sexual experiences with adults were collected from 120 women attending general-practice surgeries and 115 women psychiatric patients. The method of study, research team and county of residence were the same for the two groups. The psychiatric patients tended to report rates of events higher than the general-practice attenders by a factor of 2-3. The results suggest an association between such experiences and later psychiatric patienthood and are compatible with a causal role for them in some cases.

Adolescent↗
PubMed1993

High-dose carboplatin and recombinant granulocyte-macrophage colony-stimulating factor in advanced-stage recurrent ovarian cancer.

PURPOSE: We investigated whether carboplatin myelosuppression could be favorably modulated by the administration of recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF) in patients with advanced-stage ovarian cancer. PATIENTS AND METHODS: Thirty-four patients with advanced-stage recurrent ovarian cancer were treated with high-dose carboplatin (800 mg/m2 per 35-day cycle) and rGM-CSF. rGM-CSF was administered as a daily subcutaneous injection starting 72 hours after the carboplatin dose and continuing until 7 days beyond the WBC nadir. rGM-CSF was administered in a phase I fashion. Seven patients were treated at an rGM-CSF dose of 3 micrograms/kg, 11 at 5 micrograms/kg, 10 at 10 micrograms/kg, and six at 20 micrograms/kg. RESULTS: rGM-CSF-related toxicities that were not dose-related included nonneutropenic fever, rib pain, acute hypersensitivity reaction, and pericarditis. At the rGM-CSF dose of 20 micrograms/kg, debilitating malaise was seen in four of six patients and this was the dose-limiting toxicity. Patient tolerance of the 3-micrograms/kg and 5-micrograms/kg doses was good, but tolerance was limited for the 10-micrograms/kg dose. Febrile neutropenia was seen in four of seven patients at 3 micrograms/kg, two of 11 at 5 micrograms/kg, two of 10 at 10 micrograms/kg, and one of six at 20 micrograms/kg. Cumulative carboplatin myelotoxicity was blunted only in respect to WBC count, and not for platelets or RBCs. Gastrointestinal bleeding was seen in seven patients. The administered dose-intensity of carboplatin averaged 134 mg/m2/wk for the cohort, or 670 mg/m2 per 35-day cycle. There were two clinical complete responses and eleven partial responses, for a response rate of 38%. CONCLUSION: rGM-CSF appears to be effective and tolerable at 5 micrograms/kg/d administered subcutaneously, if given with carboplatin doses up to approximately 600 mg/m2 over 35 days. The use of rGM-CSF with high-dose carboplatin is associated with a substantial response rate in poor-prognosis ovarian cancer patients.

Adult↗
PubMed1993

Magnetic resonance imaging in childhood intractable partial epilepsies: pathologic correlations.

We conducted a retrospective single-blind study assessing the value of MRI in 44 children surgically treated for partial epilepsy, and correlated the MRI findings with the pathology in all cases. MRI revealed abnormalities in concordance with the clinical and electroencephalographic data in 84% of patients. Developmental neuronal migration pathology was present in 25% of patients and was relatively more common in the sensorimotor cortex. There was hippocampal sclerosis in 50% of patients with temporal lobe resection; however, only two of the 10 children with hippocampal sclerosis were below the age of 12 years. Similarly, ganglio-glial tumors were more common than astrocytomas in children below age 12. These results indicate that MRI is sensitive in the detection of pathologic abnormalities in most pediatric candidates for epilepsy surgery, and that the distribution and type of pathology appear to be age related in this population.

Adolescent↗
PubMed1993

Abbott AxSYM random and continuous access immunoassay system for improved workflow in the clinical laboratory.

We describe a new clinical laboratory instrument, the Abbott AxSYM, which provides random- and continuous-access testing for immunoassays, 20 onboard reagents, primary tube sampling, and a throughput of 80 to 120 tests per hour. The AxSYM incorporates three separate analytical technologies for processing immunoassays: microparticle enzyme immunoassay, fluorescence polarization immunoassay, and a novel technology known as ion-capture immunoassay. The system incorporates both common and technology-specific subsystems controlled by a real-time software scheduling processor. Tests can be processed in one- or two-step sandwich or competitive formats, with variable pipetting steps, incubation periods, optical read formats, and wash sequences. Menu capabilities include tests for hepatitis, retrovirus, tumor markers, fertility markers, thyroid functions, and therapeutic drugs. The time to first result is approximately 15-25 min for most routine assays and < or = 15 min for stat assays (i.e., creatine kinase MB isoenzyme, human chorionic gonadotropin beta subunit, and therapeutic drugs). AxSYM assay performance for 23 assays was comparable with that of the Abbott IMx and TDx analyzers; specimen correlation data had correlation coefficients ranging from 0.97 to 0.99 and slopes ranging from 0.99 to 1.10. Within-run imprecision (CV) was 1.5% to 11.4%, with most assays (19 of 23) demonstrating CVs < or = 8.0%.

Autoanalysis↗
PubMed1993

Effect of moderate exercise on proliferative responses of peripheral blood mononuclear cells.

We studied the effects of 30 minutes of exercise on T lymphocyte counts and proliferative responses of peripheral blood mononuclear cells (PBMC) in 25 runners. Exercise resulted in a T lymphocytosis in the immediate post-exercise period in all subjects (p < 0.001), and reduced CD4+/CD8+ ratios in 22/25 subjects (p = 0.001). The change was due primarily to a 2.2-fold increase in CD8+ cells (p < 0.001). Exercise also reduced PBMC mitogenic responses to phytohemagglutinin (PHA) in 13/14 subjects (p = 0.049), and to pokeweed mitogen (PWM) in 11/14 subjects (p = 0.022), but not to concanavalin A. Postrun sera from 5 of 6 subjects inhibited PHA but not PWM responses of resting autologous PBMC with normal CD4+/CD8+ ratios (p < or = 0.05): indomethacin and monocyte depletion blocked the serum inhibition (p = 0.003, p = 0.0006, respectively). We conclude that post-exercise suppression of mitogenic responses to PHA is due to the release of a serum factor(s) capable of inducing prostaglandin synthesis by circulating monocytes, whereas exercise-induced suppression of PWM responses depends primarily on the reversal of CD4+/CD8+ ratios.

Adult↗