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Biomedical subjects

J Thomas

Publications and source records attributed to J Thomas.

At least 145 records · Page 8Linked to original sources
PubMed2001

Urbanisation and health related knowledge and attitudes of South Asian children.

OBJECTIVE: To study the differences in health related knowledge and attitudes of less and more urbanised 10-12 year old South Asian school children. METHOD: A total of 589 Asian children living in UK and in Pakistan were studied. Three groups of children were recruited from Punjab, Pakistan: rural (RrP, n = 100), middle income urban (MUP, n = 148) and high income urban (HUP, n = 159) and they were assigned urbanization rank (UR) 1, 2 and 3. Another two groups of children were recruited from Slough, UK: British Pakistani (BrP, n = 110) and British Indian (Brl, n = 71) and they were assigned urbanization rank 4 and 5 respectively. Information about Cardiovascular Health (CVH) related knowledge, Health Locus of Control (HLC), smoking behaviour, self-perception of bodyweight and self-perception of activity level was collected through questionnaire. Actual weight status was judged by measuring body height and weight. Actual Physical Activity Level (PAL) was calculated from three day activity records kept by children. RESULTS: In general health related knowledge improved with urbanisation status. In all groups girls scored better on knowledge test than boys from the same group. HLC scores increased (indicate higher level of internal locus of control) steadily with urbanisation from UR 1-3. In most groups girls had slightly lower HLC scores. Smoking intentions were not related to UR. Validity of perceptions slightly improved with urbanisation rank only for activity level. CONCLUSION: Due to lack of knowledge and belief in external health locus of control, behaviour modification is likely to harder in less urbanized Pakistani groups. For the prevention of disease, efforts are required not only to increase the children's knowledge about health but also to increase awareness and understanding of healthy body weight, physical activity, hazards of smoking and to inculate belief in internal control over own health.

Analysis of Variance↗
PubMed2000

Disparity between whites and african-americans in knowledge and treatment of cholesterol. Carolina heart survey.

PURPOSE: Elevated cholesterol is a known risk factor for coronary heart disease and studies have demonstrated a decrease in myocardial infarctions and strokes in those treated with cholesterol-lowering medications. A statewide survey was conducted to determine knowledge and treatment of cholesterol in South Carolina residents.METHODS: In 1998, a random digit telephone survey was conducted of 1200 adults in South Carolina, including 28.2% African Americans (AA), using a 46-item instrument developed to quantify awareness, knowledge and treatment of cholesterol.RESULTS: Nearly 90% of both AA and Whites (W) believe high cholesterol levels can cause a "heart attack." However, more AA (90.2%) than W (82.8%) believe that high cholesterol levels cause a "stroke" (p = 0.005). Though not statistically significant, 19.5% of W compared to 23.4% of AA reported not ever having their cholesterol checked (p = 0.066). Of those who had their cholesterol checked, less than half (47%) knew their most recent cholesterol or knew a "good" cholesterol level for an adult (41%). Fewer AA could recall their cholesterol level (p = 0.011), or knew a "good" cholesterol level for an adult (p < 0.001) as compared with W. Of the 24.2% who were told they had elevated cholesterol, 59% were under the care of a physician for cholesterol treatment, of which 56.6% reported taking cholesterol-lowering medications. There was a significant difference in the reported treatment with cholesterol-lowering medications between W and AA, 63% versus 33%, respectively (p = 0.006) and ranged from a high of 73.5% in W males to 29.4% in AA females (p = 0.005).CONCLUSIONS: The results of this population assessment suggest less knowledge about cholesterol among AA and racial disparity with regard to treatment with medications of elevated cholesterol levels.

Journal Article↗
PubMed2000

Assessment of a patient-based pharmaceutical care scale.

The Purdue Pharmacist Directive Guidance scale (PPDG), which is designed to measure patients' perceptions of the level of directive guidance received from pharmacists, was studied. Hypertension patients were interviewed by telephone between July 15 and August 15, 1998, with a survey including the PPDG, the Medication Adherence Scale (MAS), and the Friends and Family Support scale (FFS). The Behavioral Pharmaceutical Care Scale (BPCS) was mailed between May 15 and July 15, 1998, to pharmacies from which the patients obtained most of their prescriptions. The MAS measures patients' medication adherence, and the FFS measures their perceptions of the social support they receive from family and friends. Analysis of variance was used to assess whether there was significant variation in scale scores across pharmacies. Pearson correlation analysis was used to assess simple correlation among scales, and regression analysis was used to examine the association between scale scores while controlling for demographic variables, family support, and number of prescription drugs taken. Interviews with 163 patients were analyzed, and 64 pharmacists representing 32 pharmacies responded. The PPDG did not detect any difference across pharmacies in patients' perceptions of the level of directive guidance received. There was no significant correlation between PPDG scores and pharmacists' perceptions of the level of pharmaceutical care provided as measured with the BPCS or between PPDG scores and MAS scores. The findings reconfirmed the PPDG's reliability and factor structure and provided some evidence of convergent validity. The PPDG was reliable. Evidence of validity was not conclusive, although the high threshold for validity may have been responsible for this.

Adult↗
PubMed2000

Thrombomodulin overexpression to limit neointima formation.

BACKGROUND-These studies were initiated to confirm that high-level thrombomodulin overexpression is sufficient to limit neointima formation after mechanical overdilation injury. METHODS AND RESULTS-An adenoviral construct expressing thrombomodulin (Adv/RSV-THM) was created and functionally characterized in vitro and in vivo. The impact of local overexpression of thrombomodulin on neointima formation 28 days after mechanical overdilation injury was evaluated. New Zealand White rabbit common femoral arteries were treated with buffer, viral control, or Adv/RSV-THM and subjected to mechanical overdilation injury. The treated vessels (n=4 per treatment) were harvested after 28 days and evaluated to determine intima-to-media (I/M) ratios. Additional experiments were performed to determine early (7-day) changes in extracellular elastin and collagen content; local macrophage, T-cell, and neutrophil infiltration; and local thrombus formation as potential contributors to the observed impact on 28-day neointima formation. The construct significantly decreased neointima formation after mechanical dilation injury in this model. By histological analysis, buffer controls exhibited mean I/M ratios of 0.76+/-0.06%, whereas viral controls reached 0.77+/-0.08%; in contrast, Adv/RSV-THM reduced I/M ratios to 0.47+/-0.06%. Local inflammatory infiltrate decreased in the Adv/RSV-THM group relative to controls, whereas matrix remained relatively preserved. Rates of early thrombus formation also decreased in Adv/RSV-THM animals. CONCLUSIONS-This construct thus offers a viable technique for promoting a locally neointima-resistant small-caliber artery via decreased thrombus bulk, normal matrix preservation, and decreased local inflammation without the inflammatory damage that has limited many other adenoviral applications.

Animals↗
PubMed2000

CMV viral load measurements in whole blood and plasma--which is best following renal transplantation?

BACKGROUND: Quantitative commercial assays for cytomegalovirus (CMV) detection have recently been developed. Their role in the management of patients after transplantation needs to be evaluated. Widespread use of these assays will allow for comparison of results between centers and meaningful interpretation of the significance of viral load measurements. METHODS: Sequential samples from 52 patients after renal transplantation were tested in the murex hybrid capture assay (HCA) and the Roche Amplicor CMV DNA assay (QPCR) and correlated with the development of CMV disease. A comparison of viral loads in plasma and whole blood was also made. RESULTS: Both assays were sensitive and detected all cases of CMV disease. The specificity and positive predictive value increased from 0.34 and 0.36 to 0.85 and 0.96 for the HCA and 0.37, 0.37 to 0.72 and 0.63 for the QPCR following a receiver operator curve analysis. Higher viral loads were measured using the HCA compared to the QPCR. Response to ganciclovir was associated with a greater than 80% reduction in viral load by HCA or greater than 70% using the QPCR. CONCLUSIONS: Both assays were highly sensitive. By using a receiver operator curve analysis a cutoff viral load can be determined which maximizes the clinical utility of these assays.

Adult↗
PubMed2000

Analysis of the P53, RB/D13S25, and P16 tumor suppressor genes in marginal zone B-cell lymphoma: An interphase fluorescence in situ hybridization study.

The genetic mechanisms underlying the genesis, disease progression, and high-grade transformation of marginal zone B-cell lymphoma (MZBCL) are poorly understood. We analyzed 33 cases of histologically and immunophenotypically well-characterized MZBCL (12 extranodal, 11 nodal, and 10 splenic MZBCL; 27 at primary diagnosis and six during the course of disease) by dual-color interphase fluorescence in situ hybridization (FISH) for deletions of tumor suppressor genes. We investigated loci known to play a role in the genesis or disease progression of other subtypes of lymphoid malignancies, namely the P53 gene (17p13), the retinoblastoma gene (RB, 13q14), the D13S25 locus (13q14), and the P16(INK4A) gene (9p21). Heterozygous deletions of P53 were detected in three out of the 33 cases, including two splenic and one extranodal MZBCL. One of these patients was analyzed at primary diagnosis and two during the course of disease. Heterozygous deletions of the RB gene (nodal MZBCL) and D13S25 (splenic MZBCL) were found in one case each. P16 deletions were not detected in any of our cases. We conclude that deletions of the analyzed tumor suppressor genes are relatively rare in MZBCL, which contrasts with the findings in some other subtypes of NHL.

Aged↗
PubMed2000

ATP stimulates Cl- secretion and reduces amiloride-sensitive Na+ absorption in M-1 mouse cortical collecting duct cells.

1. Using equivalent short circuit current (ISC) measurements we examined the effect of extracellular ATP on transepithelial ion transport in M-1 mouse cortical collecting duct cells. Apical addition of ATP produced a rapid transient peak increase in ISC. This was followed by a fall below basal ISC due to a reduction in the amiloride-sensitive ISC component. 2. The ATP-induced ISC increase was preserved in the presence of apical amiloride while it was reduced in the absence of extracellular Cl- and in the presence of the apical Cl- channel blockers diphenylamine-2-carboxylic acid (DPC, 1 mM), DIDS (300 microM) and niflumic acid (100 microM). 3. The stimulatory effect of apical ATP on ISC was concentration dependent with an EC50 of about 0.6 microM. Basolateral ATP elicited a similar ISC response. Experiments using the ATP scavenger hexokinase demonstrated that the ATP effects were elicited via separate apical and basolateral receptors. 4. ATP and UTP applied to either the apical or the basolateral bath equi-potently stimulated ISC while 'purified' ADP and UDP had no effect consistent with P2Y2 purinoceptors, the expression of which was confirmed using RT-PCR. 5. Intracellular calcium concentration ([Ca2+]i) measurements using fura-2 demonstrated that ATP and UTP elicited a rise in [Ca2+]i with EC50 values of 1.1 and 0.6 microM, respectively. The shape and time course of the calcium response were similar to those of the ISC response. The peak ISC response was preserved in the nominal absence of extracellular calcium but was significantly reduced in cells pre-incubated with the calcium chelator BAPTA AM. 6. We conclude that in M-1 cells extracellular ATP reduces amiloride-sensitive Na+ absorption and stimulates Cl- secretion via calcium-activated Cl- channels through activation of P2Y2 purinoreceptors located in the apical and basolateral membrane.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed2000

Discovery of doubly magic 48Ni

In an experiment at the SISSI/LISE3 facility of GANIL, we used the projectile fragmentation of a primary 58Ni26+ beam at 74.5 MeV/nucleon with an average current of 3 &mgr;A on a natural nickel target to produce very neutron-deficient isotopes. In a 10-day experiment, 287 42Cr isotopes, 53 45Fe isotopes, 106 49Ni isotopes, and 4 48Ni isotopes were unambiguously identified. The doubly magic nucleus 48Ni, observed for the first time, is the most proton-rich isotope ever identified with an isospin projection T(z) = -4. It is probably the last doubly magic nucleus with "classical" shell closures accessible for present-day facilities. Its observation allows us to deduce a lower limit for the half-life of 48Ni of 0.5 &mgr;s.

Journal Article↗
PubMed2000

Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomised controlled trial.

BACKGROUND: Pulmonary rehabilitation seems to be an effective intervention in patients with chronic obstructive pulmonary disease. We undertook a randomised controlled trial to assess the effect of outpatient pulmonary rehabilitation on use of health care and patients' wellbeing over 1 year. METHODS: 200 patients with disabling chronic lung disease (the majority with chronic obstructive pulmonary disease) were randomly assigned a 6-week multidisciplinary rehabilitation programme (18 visits) or standard medical management. Use of health services was assessed from hospital and general-practice records. Analysis was by intention to treat. FINDINGS: There was no difference between the rehabilitation (n=99) and control (n=101) groups in the number of patients admitted to hospital (40 vs 41) but the number of days these patients spent in hospital differed significantly (mean 10.4 [SD 9.7] vs 21.0 [20.7], p=0.022). The rehabilitation group had more primary-care consultations at the general-practitioner's premises than did the control group (8.6 [6.8] vs 7.3 [8.3], p=0.033) but fewer primary-care home visits (1.5 [2.8] vs 2.8 [4.6], p=0.037). Compared with control, the rehabilitation group also showed greater improvements in walking ability and in general and disease-specific health status. INTERPRETATION: For patients chronically disabled by obstructive pulmonary disease, an intensive, multidisciplinary, outpatient programme of rehabilitation is an effective intervention, in the short term and the long term, that decreases use of health services.

Aged↗
PubMed2000

Adult Chediak-Higashi parkinsonian syndrome with dystonia.

Chediak-Higashi syndrome (CHS) is a rare autosomal-recessive disorder characterized by immune deficiency, partial oculocutaneous albinism, and large eosinophilic, peroxidase-positive inclusion bodies in granule-containing cells. The adult form of CHS manifests during late childhood to early adulthood and is marked by various neurologic sequelae, including parkinsonism, dementia, spinocerebellar degeneration, and peripheral neuropathy. We report the case of a 29-year-old man with adult CHS who exhibited a progressive asymmetric parkinsonism, including rest tremor, and axial, cervical, and appendicular dystonia. The diagnosis was confirmed by the presence of characteristic large peroxidase-positive granules within leukocytes and markedly decreased natural killer cell function. Levodopa/carbidopa and amantadine provided benefit for tremor. CHS, although rare, should be considered in the differential diagnosis of young adult parkinsonism.

Adult↗
PubMed2000

Transcutaneous electrical nerve stimulation does not augment combined spinal epidural labour analgesia.

PURPOSE: The spinal portion of the combined spinal epidural technique (CSE) provides dramatic but limited labour analgesia. Transcutaneous Electrical Nerve Stimulation (TENS) has been noted to modulate pain, in part by the frequency of stimulation chosen. Because nerve action potentials are blocked by local anesthetics in a frequency dependent manner, we speculated that a TENS unit could increase the quality and duration of the spinal portion of a CSE. METHODS: Forty parturients in active spontaneous labour, with a singleton, vertex, term fetus, requesting analgesia were enrolled in a randomized, double blind fashion to receive a standardized CSE with either an active or inactive TENS unit. Prior to CSE placement, TENS intensity thresholds were determined with electrodes placed on the paraspinus muscles at T10-L1, and S2-4; TENS settings for mode, cycle, and pulse width were standardized. Data were collected at timed intervals on pain (VAS), sensory level (pinprick), motor blockade (Bromage), cervical dilatation, and duration of analgesia, and at delivery on fetal and neonatal outcome. RESULTS: The duration of the spinal portion of the CSE did not differ between groups (TENS off 91.1+/-33 [mean +/- SD] vs. TENS on 83.1+/-28 min, P = .42). Kaplan-Meier survival analysis and Mantel-Cox log rank analysis showed no difference between the two treatments (P = .28). Analgesia was comparable throughout the first hour of spinal analgesia. CONCLUSION: In healthy labouring parturients, the application of a TENS unit did not alter the quality or duration of labour analgesia provided by the spinal portion of CSE analgesia.

Adult↗
PubMed2000

Free and total magnesium in lymphocytes of migraine patients - effect of magnesium-rich mineral water intake.

Dietary surveys performed in Western countries show magnesium intakes lower than the recommended dietary allowances, suggesting a large prevalence of magnesium deficiency. Low brain magnesium as well as impaired magnesium metabolism have also been reported in various diseases such as migraine. To detect these deficiencies, a non-invasive and sensitive test assessing magnesium status is needed. Because magnesium is an intracellular cation, either total or ionized magnesium (Mg(2+)) of blood cells were suggested as the most adequate tests. Total magnesium levels in plasma, erythrocytes and lymphocytes and Mg(2+) in lymphocytes were analyzed in a group of 29 migraine patients and 18 control subjects. Results show significantly lower concentrations of total magnesium in erythrocytes (50.7+/-4.7 vs. 53.5+/-2.9 mg/l; P<0.01) and of Mg(2+) in lymphocytes (12.0+/-3.5 vs. 14.2+/-3.8 mg/l; P<0.05) in migraine patients as compared to controls. While a significant difference of mean values was noted between migraine patients and controls, an overlap of individual values was observed. These analyses were repeated on migraine patients before and after a 2-week intake of a mineral water containing 110 mg/l magnesium, and a significant increase in all intracellular magnesium concentrations with no effect on plasma magnesium was observed. These increased intracellular magnesium concentrations demonstrate the bioavailability of magnesium from this mineral water. Among the analyzed parameters, Mg(2+) in lymphocytes appears to be the most sensitive index of magnesium deficiency with a 15% decrease in migraine patients when compared to controls and a 16% increase after 2 weeks of a magnesium-rich mineral water intake.

Adult↗
PubMed2000

Risk factors in school shootings.

Nine incidents of multiple-victim homicide in American secondary schools are examined and common risk factors are identified. The literature dealing with individual, family, social, societal, and situational risk factors for youth violence and aggression is reviewed along with existing risk assessment methods. Checklists of risk factors for serious youth violence and school violence are used in reviewing each school shooting case. Commonalties among the cases and implications for psychologists practicing in clinical and school settings are discussed.

Adolescent↗