Primary health care in India.
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Biomedical subjects
Publications and source records attributed to J Turner.
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Immunocytochemistry of the locust central nervous system shows that most segmental nerves, in particular those of the legs, contain afferent fibres that react with antibody to 5-hydroxytryptamine (5-HT). Adsorption controls indicate that the antigen is 5-HT or a closely related compound. This is supported by the finding of significant amounts of 5-HT in leg nerves using reverse phase high-performance liquid chromatography (HPLC) and electrochemical detection. On the other hand 5-HT was not detectable in locust antennal and cercal nerves with either immunocytochemistry or with HPLC. These results strongly support that some populations of sensory neurones in the locust contain 5-HT.
Twenty-one clinical, biochemical, scan and tracer-kinetic parameters were documented in 76 patients with Graves' disease who had received a standard 5-mCi therapy dose of 131I. Linear discriminant analysis was then undertaken to determine what combination of variables best predicted outcome. One year after therapy, 40 patients were euthyroid, 11 were hypothyroid, and 25 were still thyrotoxic. Linear discriminate functions combining 24-h 131I uptake, the presence or absence of thyroid eye signs and a computer-derived measurement of thyroid cell mass best discriminated the three outcome groups. The proportion of patients correctly reclassified according to outcome using these functions was, however, only just over 50%. It is concluded that no single or combination of pretreatment variables predicts early outcome with sufficient confidence to justify a rigorously 'scientific' approach to the administration of 131I therapy for Graves' disease.
Neurosurgical procedures in patients with severe haemophilia carry a major risk of bleeding. We describe successful thermocoagulation of the trigeminal nerve for neuralgia in a severe haemophiliac, under cover of factor VIII concentrate. This is the first case report of such an operation in severe haemophilia.
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A revised objective rating system for patient selection for lumbar laminectomy and discectomy in the treatment of disc herniation is presented. Based on the severity of the findings within each of four categories (neurologic signs, root tension signs, myelogram or CT scan findings, and psychosocial environment), numerical scores are derived. A maximum score of 25 points is available in each category, for a total of 100 points. The objective rating score was determined prospectively in 106 patients who were treated by laminectomy for lumbar disc herniation and who were evaluated at least one year after surgery. The rating score was highly predictive of the surgical result. Application of this system for patient selection would reduce reliance on much of the subjective interpretation of physical and radiographic findings. With appropriate patient selection, improved surgical results are possible.
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Of 28 788 women aged 40 to 74 registered at 28 university teaching practices in greater Belfast, half were randomly selected to receive a booklet on breast self-examination from their general practitioner at the start of the study and 1 year later. The frequency of breast abnormalities was identical in both groups (0.83%) during the 2-year follow-up. Early malignant breast cancers (stages TX, TO, Tla) were significantly more frequent in the intervention group (53.6%) than in the control group (24.3%). Among women in the intervention group with malignant lesions, 2 sites, left nipple and left inner/upper quadrant, were significantly less frequently involved. These findings in relation to staging and site were confirmed by multivariate comparisons. The intervention group also had a smaller average tumour size (24.0 mm compared with 32.6 mm) due to significantly smaller benign tumours and the absence of the relationship between delay and tumour size evident in the control group.
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Examined the relationship between locus of control and psychological disorder in chronic pain patients controlling for the effects of response sets. Fifty-nine patients with chronic low back pain were given Rotter's Internal-External Locus of Control (I-E) scale and the MMPI. Multiple regression analysis showed that the MMPI K, F, and Pt scales produced the most efficient prediction of I-E scores. Response set tendencies to dramatize problems and traits that involve excessive rumination and self-doubt were related to external locus of control.
Plaque samples from caries lesions, white spot margins of these lesions, and caries-free smooth enamel surfaces, obtained from seven subjects with nursing bottle caries, all contained unusually high proportions of Streptococcus mutans. The proportion of lactobacilli present in plaque from caries lesions was statistically greater (p less than 0.01) than the proportion present in plaque obtained from white spot margins of these lesions or caries-free smooth enamel surfaces.
Release of the amino acid neurotransmitter candidates aspartate and glutamate from synaptosomes can be stimulated by reduction of [Cl-] in the incubation medium by replacement with the impermeant anions propionate and isethionate. Replacement by the permeant anion Br- is without effect on amino acid release. This release offers a biochemical method of studying the Cl-ion channel in CNS membrane.
Calcium hydroxide pulpotomies were performed in 17 carious primary mandibular molars. Variables in the pulpotomy procedure were recognized and controlled in an attempt to obtain a more favorable result or end product. The effects of two methods of hemorrhage control were also evaluated. The duration of treatment for the study ranged from three to nine months. Treatment was clinically successful for all 17 teeth. The radiographic evaluations were more favorable for the experimental group than for the control group. Treatment was radiographically successful for 15 teeth, questionable for one tooth, and unsuccessful for one other tooth. The results of this study suggest that the aluminum chloride-calcium hydroxide pulpotomy may be a viable alternative to formocresol pulpotomies in the primary dentition. Although these findings encourage continued research, including a long-term follow-up, a histologic study is indicated.
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The use of avidin-biotinylated peroxidase as a simple technique for light microscopic visualization of spirochetes is described. The three major genera of spirochetes--Treponema, Borrelia, and Leptospira--were stained with the avidin complex.
In a double-blind study, patients with moderate to severe essential hypertension were treated randomly with either indoramin or propranolol orally. The dose of both drugs was increased as necessary, to a predetermined level, in order to reduce the diastolic (Phase V) blood pressure to 100 mmHg or less. Patients were followed up for 12 weeks. There were 23 patients on propranolol and 27 on indoramin. The blood pressure in 22 patients on propranolol and 25 patients on indoramin was satisfactorily controlled in both the supine and standing positions. Mean supine blood pressure decreased from 181.3 +/- 14.2/116.2 +/- 6.8 mmHg to 140.6 +/- 7.1/95.7 +/- 3.6 mmHg after 12 weeks of treatment in patients receiving propranolol and from 188.3 +/- 18.9/118.4 +/- 8.7 mmHg to 144.7 +/- 7.3/95.7 +/- 2.5 mmHg in those treated with indoramin. There were no significant differences between the effects on supine and standing blood pressures and blood pressure control was maintained throughout the 12-week period in patients receiving indoramin and those receiving propranolol. Propranolol reduced the mean heart rate by approximately 16 beats/min in both the supine and standing positions. The maximum effect was seen 4 weeks after starting treatment and was maintained throughout the study. Sinus bradycardia (heart rate less than 60/min) occurred in 9 (39%) patients receiving propranolol. Indoramin caused a small but significant reduction in mean heart rate of approximately 4 beats/min in both the supine and standing positions. The maximum effect was seen after 2 weeks of treatment and was maintained for the rest of the duration of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)