Deep vein thrombosis: an unexpected killer.
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Biomedical subjects
Publications and source records attributed to J Turner.
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The rhodizonic acid method for the determination of SO2-4 has been used to investigate the glycosulphatase activity of the sulphatase A (aryl-sulphate sulphohydrolase, EC 3.1.6.1) of ox liver. Sulphatase A hydrolyses D-glucopyranose and D-galactopyranose 2-, 3-, 4- and 6-sulphates: glucose sulphates are hydrolysed more rapidly than galactose sulphates and the 3-sulphates more rapidly than the other isomers. 2-Acetamido-2-deoxyglucopyranose 6-sulphate is not hydrolysed, nor is 2,3,4,6-tetra-O-acetyl-beta-D-glucopyranose 1-sulphate. Sulphate is a competitive inhibitor of the glycosulphatase activity. Hydrolysis proceeds through fission of the O-S bond. Evidence is given that the hydrolysis of glucose 3-sulphate is accompanied by the formation of substrate-modified sulphatase A, although this has not been isolated. Sulphatase A has no detectable alkylsulphatase activity.
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Greyhound dogs were given oleic acid i.v. to induce controlled pulmonary oedema. These animals were then studied using intermittent positive pressure ventilation (IPPV) with four different inspiratory flow waveforms, each at three different inspiratory times, in a fixed respiratory cycle of 4 s at a constant tidal volume. Although there were statistically significant differences in airway and oesophageal pressures between the different waveforms and times, there was little variation in the other physiological parameters studied except for arterial carbon dioxide tension. (PaCO2) which showed statistically significant improvement with reversed ramp and sine wave inputs and at the longer inspiratory time of 2.2s. Venous admixture (Qs/Qt) was also less with the longer inspiratory time of 2.2s.
The action of peridural morphine (1.5, 3.0 and 5.0 mg) as compared to placebo was studied in the patients who underwent inguinal hernia repair or lower extremity surgery under peridural anaesthesia. Morphine produced a dose-dependent intensive and long lasting segmental analgesia which was statistically significantly superior to placebo at all dosages. This action was however accompanied by a high incidence of urine retention and vomiting. We did not find any respiratory or circulatory depression. Nevertheless, it is accentuated that under different clinical conditions this depression might be highly probable.
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Efforts to eliminate the shortage of psychiatrists in rural areas have been relatively unsuccessful due to the special personal and professional problems facing the rural psychiatrist. The rural psychiatrist may feel personally isolated, encountering a somewhat foreign culture and living in uncomfortable proximity to patients and their families. He may feel professionally frustrated, for his physician colleagues are usually conservative and hold dear the medical model of care. He may suffer the typical frustrations of the psychiatrist working out of a community mental health center, and has little opportunity for professional growth. Academic training centers that train psychiatrists in region where they will work can more adequately prepare trainees for rural practice and can offer continuing education courses to professionals already practicing in the area. These centers should collaborate with mental health facilities to define and respond to manpower problems. Finally, opportunities for rural practitioners to make shifts in career emphasis over time should be created.
If a campaign to encourage women to examine their breasts for lumps is to succeed, it is necessary for women to read the literature produced. An attempt was made to estimate whether such literature was read, and in a group of women 90.6 per cent read the booklet, and 15.9 per cent altered their behaviour. There were several other non-numerical indicators which strongly suggested that women read the literature. A large-scale study is now under way.
Treated chronic low back pain patients (N = 102) in a university hospital clinic. Ss were given the EPI, the Recent LIfe Changes Questionnaire, and the Locus of Control Scale in order to isolate the principal dimensions of emotional disturbance in such patients and to see whether derived dimensions were related to response to conservative treatment for back pain. Self-report ratings of current pain intensity were obtained approximately 1 year after the start of treatment. Factor analysis revealed five factors: Distrust and alienation, somatic concern, vulnerability, extraversion, and social desirability; these accounted for 71% of the total variance among patients. Patients with above-average pretreatment distrust and alienation scores more frequently failed to return the follow-up form than patients with below-average scores. Low scores on somatic concern were related to good outcome. Results suggest that patients in alienation and distrust may be prone to be poor compliers. Because only the somatic concern dimension predicted outcome, a single scale that measures this characteristic may be sufficient for effective identification of the potential good vs. poor responders to conservative treatment of low back pain.
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A population of 1,496 women aged 55 to 74 years was studied for the distribution of heart disease risk factors in the presence or absence of postmenopausal estrogens. Current hormone use was reported by 39%. Hormone users were significantly slimmer than nonusers at all ages. After adjustment for the effect of obesity, hormone users had significantly lower mean levels of plasma cholesterol and higher mean levels of plasma triglycerides than nonusers. Blood pressure and fasting plasma glucose concentration tended to be lower among hormone users, although the differences were not statistically significant in all age groups. This article discusses the theoretical implications of these observations for cardiovascular disease mortality and contrasts them with the cancer risk of postmenopausal estrogen use.
Studies that used the MMPI to predict the response of chronic low back pain patients to standard medical treatment have not produced definitive results. Patients seen in a university hospital orthopedic back pain clinic were given the MMPI before treatment, and 6 to 12 months later 76 patients completed follow-up forms that indicated their level of intensity during the previous week and their ratings of the success of treatment in relieving their pain as well as in enabling them to return to normal activities. Predictions of poor response were made in terms of either single MMPI scales or code types. Patients with poor outcome on two of the three criteria (level of pain intensity and ability to return to normal activities) had significantly higher scores on the Hs scale. The predicted high risk code types very accurately identified patients with poor response on the same two criteria; however, the code-type procedure overpredicted poor response in the good outcome group.
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