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Biomedical subjects

J Watson

Publications and source records attributed to J Watson.

At least 163 records · Page 9Linked to original sources
PubMed1995

Comparison of short term outcomes of open and laparoscopic cholecystectomy.

OBJECTIVE: To compare the three month outcome of open and laparoscopic cholecystectomy. DESIGN: Prospective assessment of outcome for a series of patients encompassing the introduction of the laparoscopic technique. SETTING: One teaching hospital. PATIENTS: 269 patients admitted for open cholecystectomy between January 1989 and March 1992 and 122 admitted for laparoscopic cholecystectomy between January 1991 and March 1992. MAIN MEASURES: Patients' reported symptoms and self assessed scores with the Nottingham health profile before operation and at three month follow up. Incidence of complications and adverse events after discharge. RESULTS: Similar improvements in symptom rates and health scores were seen regardless of surgical technique. A lower rate of postoperative complications was seen in the patients given laparoscopic surgery (6/95(6%) v 45/235(19%)), and their mean length of stay was lower (4.5 v 9.8 days). Similar results were obtained when the analysis was restricted to a subset of fairly uncomplicated cases (patients aged 60 or less without other illnesses on admission who were not undergoing emergency or urgent surgery), which constituted a larger proportion of the group given laparoscopy (35/95(37%) v 40/235(17%)). Between these two groups no significant difference was seen in the frequency of relevant readmissions to hospital or visits to general practitioners or accident and emergency departments. CONCLUSION: Ideally, a new surgical technique would be evaluated in a randomised trial. In the absence of such a trial, this observational study provides some evidence that the switch from open to laparoscopic cholecystectomy has brought benefits, particularly in terms of reduced length of stay in hospital. A range of clinical and patient derived indicators suggests that these gains have not been associated with a reduction in the quality of the outcome at three months.

Cholecystectomy↗
PubMed1995

Postmodernism and knowledge development in nursing.

Postmodernism as a concept and periodizing point between centuries has been defined as both the beginning and the end of modernity. This article explores some of the dimensions of this moment and movement between centuries and the implications of the postmodern condition on the nursing profession. Amidst the health care reform angst of deconstructing and reconstructing, challenges and opportunities await nursing's evolution into its own postmodern paradigm. Manifestations of such a postmodern paradigm are already reflected in the epistemological shifts of nursing science and knowledge development. Challenges posed for nursing science by this disorientingly free-floating era are brought to light--away from the reaction worldview, past the reciprocal and into the transformative-simultaneous, whereby nursing can emerge within its own unique postmodern discipline.

Health Care Reform↗
PubMed1995

Production and characterisation of monoclonal and polyclonal antibodies to different regions of the cystic fibrosis transmembrane conductance regulator (CFTR): detection of immunologically related proteins.

We have raised mouse monoclonal antibodies to eight synthetic peptides corresponding to different regions of the human cystic fibrosis transmembrane conductance regulator (CFTR) and rabbit polyclonal antisera to beta-galactosidase fusion proteins which encompass three different regions of CFTR. Immunoblot, immunoprecipitation, immunofluorescence and immunocytochemical experiments demonstrate that, in addition to recognising CFTR, these antibodies recognise one or more immunologically related proteins with a similar molecular mass, calcium responsiveness and tissue distribution to CFTR.

Amino Acid Sequence↗
PubMed1995

Prevalence of nifedipine-induced gingival hyperplasia.

This study investigated the prevalence of gingival hyperplasia in subjects who were undergoing treatment with a calcium channel blocker, nifedipine, in dentate and edentulous subjects. In addition, the relationship between gingival hyperplasia and 5 other variables (duration of nifedipine intake, dose, age, oral hygiene index, and number of teeth) was investigated. Results of statistical analyses showed overwhelming evidence that the percent of nifedipine subjects with gingival hyperplasia was greater than that of the control subjects (P < 0.05) and that, across treatment group, the percent of dentate subjects with hyperplasia was significantly higher than that for edentulous subjects (P < 0.05). The chi2 test showed a strong univariate relationship between gingival hyperplasia and, separately, oral hygiene and number of teeth. For 24% of the subjects with gingival hyperplasia index (GHI) values of 2 or 3, gingivectomy was performed, and the tissues were prepared for histological examination. Microscopic examination of the biopsy material showed findings similar to those from previously reported cases of nifedipine- or phenytoin-induced hyperplasia.

Age Factors↗
PubMed1995

Interleukin 6 (IL-6) and soluble IL-2 receptor levels in patients with rheumatoid arthritis treated with low dose oral methotrexate.

OBJECTIVE: To investigate the effect of oral methotrexate (MTX) on circulating levels of interleukin 6 (IL-6) and soluble IL-2 receptor (sIL-2R) in patients with rheumatoid arthritis (RA). METHODS: We measured serum concentrations of IL-6 (n = 20) and sIL-2R (n = 16) before MTX therapy and again after 12 weeks. RESULTS: MTX significantly reduced IL-6 and sIL-2R after 12 weeks of therapy, and although the levels remained low at 24 weeks of therapy, the reduction was not significant. Reduction in cytokine levels was paralleled by an improvement in clinical indices. Placebo treatment did not significantly alter IL-6 or sIL-2R. CONCLUSION: MTX appears capable of cytokine modulation, although the mechanism is not clear.

Administration, Oral↗
PubMed1995

Nursing's caring-healing paradigm as exemplar for alternative medicine?

This article provides an overview of the crisis in modern (biomedical) and postmodern (human) science and method. Nursing's evolving system of caring and healing, within a unitary-transformative context, is offered as an exemplar to the growing field of alternative medicine. This framework for viewing alternative medicine paradigms and problems unveils some converging worldview assumptions that transcend nursing and have relevance to all caring-healing practices.

Complementary Therapies↗
PubMed1994

Apoptosis in L929 cells expressing a CD40/Fas chimeric receptor: dissociation of stimulatory from inhibitory death signalling functions.

A chimeric transmembrane receptor was constructed by fusing the extracellular domain of human CD40 to the transmembrane/intracellular domain of human Fas. When stably overexpressed in L929, the chimera retained the ligand binding specificity of CD40 and the basic signalling properties of Fas since an apoptotic response could be induced in a dose-dependent manner upon administration of recombinant, soluble CD40 ligand trimer or immobilized antiCD40 antibodies. However, this apoptotic response was independent of actinomycin D which is in contrast to results previously reported for L929 cells stably expressing wildtype human Fas. A labile protein factor was postulated to be responsible for inhibition of Fas-induced apoptosis in these cells. The apoptotic Fas signal tranduced by the chimeric CD40/Fas receptor is not regulated by this putative inhibitor. Our data suggest that the extracellular domains of CD40 and Fas form functionally similar mono- and multimeric structures and that the extracellular domain of Fas participates in the regulation of Fas-specific signal transduction.

Animals↗
PubMed1994

Oxygen sensitivity and metal ion-dependent transcriptional activation by NIFA protein from Rhizobium leguminosarum biovar trifolii.

The NIFA protein from Rhizobium leguminosarum biovar trifolii (R. trifolii) strain ANU843 lacks an N-terminal domain present in homologous NIFA proteins from other diazotrophs. The R. trifolii nifA gene product is unstable when expressed in Escherichia coli under both aerobic and microaerobic conditions. Stability is increased by fusion of additional amino acids to the N-terminus of the protein or by expression of nifA in sno mutant (presumed protease deficient) strains of E. coli. Transcriptional activation in vivo by R. trifolii NIFA decreases under aerobic growth conditions, or when cultures are depleted of metal ions. In sno mutant strains this decrease in activity reflects a loss of specific activity rather than proteolytic degradation, implying that R. trifolii NIFA requires metal ions for activity and is oxygen sensitive. The addition of 30 amino acids to the amino-terminus of R. trifoli NIFA results in an oxygen-tolerant protein, with metal ion-dependent activity. Metal ions are therefore not only required for oxygen sensing by R. trifolii NIFA but may play an additional role in determining NIFA structure or activity.

Amino Acid Sequence↗
PubMed1994

A pseudo outbreak of tuberculosis.

Three cases of suspected tuberculosis were diagnosed over a ten day period at an oncology unit. Case finding was carried out and six further cases were diagnosed. However, doubts were raised about these diagnoses and a review of the outbreak investigation was carried out. Investigation of laboratory procedures found that the 'outbreak' was likely to be due to a contaminated phenol red solution. This incident highlights the importance of a critical evaluation of outbreak investigations, and the need for close collaboration between clinicians, epidemiologists and laboratory staff.

Child↗
PubMed1994

The causative rhythm in out-of-hospital cardiac arrests witnessed by the emergency medical services in the Heartstart Scotland Project.

Out-of-hospital defibrillation has been shown to improve survival in out-of-hospital cardiac arrests. The maximum performance of defibrillation-based systems is dependent on the proportion of cardiac arrests due to tachyarrhythmias. We reviewed 4248 reported arrests in the Heartstart Scotland database. We identified 3489 arrests due to cardiac or unknown cause. From this group we selected 258 cases known to be conscious on arrival of the crew. We were able to retrieve electrocardiographic data on the period within 2 min of the arrest in 106 cases. The first recorded rhythm at the arrest was ventricular fibrillation in 64%, ventricular tachycardia 4%, bradycardia in 28% and electromechanical dissociation in 4%. Defibrillatory shocks were delivered to 96% of patients in ventricular fibrillation and 60% of these patients survived. None of the patients with bradycardic arrests survived. Preceding chest pain was noted in 79% of patients subsequently developing ventricular fibrillation as the cause of arrest compared to only 37% of those suffering bradycardic arrests. It would appear that public awareness of the importance of early contact with the emergency services after the onset of chest pain could substantially improve the survival from out-of-hospital arrests.

Aged↗
PubMed1994

A community outbreak of echovirus infection associated with an outdoor swimming pool.

Forty-six people became ill with vomiting, diarrhoea and headache within days of an outdoor swimming pool opening for the summer season in a small seaside village. During the weekend of the outbreak, 185 tickets to the pool had been sold. It was found that 34 bathers were ill, and one subject had vomited into the pool. All other cases arose after this incident. The risk of infection was greatest among those who swallowed pool water (24/28 versus 10/17, p = 0.07). Echovirus 30 was isolated from the case who vomited into the pool and from six other cases. Normal chlorine levels had not been adequate to contain the infection risk from vomitus, and, in future, pool attendants witnessing such incidents should consider closing the pool to the public and seeking advice on superchlorination.

Adolescent↗
PubMed1994

Production of interleukin-6 by monocytes isolated from rheumatoid arthritis patients receiving second-line drug therapy.

IL-6 production by peripheral blood monocytes isolated from RA patients receiving the second-line drugs auranofin (AUR), sulphasalazine (SASP) or gold sodium aurothiomalate (GST) was investigated. In patients receiving AUR a significant reduction in both basal and lipopolysaccharide (LPS) stimulated IL-6 production by isolated cells was observed. Similarly, SASP significantly reduced basal IL-6 production. In contrast, monocytes isolated from individuals receiving GST had no significant change either in basal or LPS stimulated IL-6 production. We suggest an effect by AUR and SASP either on pre-monocytic cells in the bone marrow or on monocytes in the periphery may subsequently result in a reduction in IL-6 production by these cells once they have infiltrated the RA joint. This may be one way by which these therapies contribute to the beneficial effects seen in patients receiving these treatments.

Arthritis, Rheumatoid↗
PubMed1994

Age and body surface area related normal upper and lower limits of M mode echocardiographic measurements and left ventricular volume and mass from infancy to early adulthood.

BACKGROUND: M Mode echocardiograms can be measured by two different conventions. In addition, normal limits of echocardiographic measurements have customarily been stratified according to age or body surface area. There is therefore a need to develop a more easily managed approach to calculating normal limits of measurements for the two conventions, one of which, the Penn convention, has not previously been used for echocardiographic measurements in children. METHODS: M mode echocardiograms were recorded in 127 healthy subjects aged from 7 months to 19.5 years. Measurements were made from paper recordings according to the recommendations of the American Society of Echocardiographers and those of the Penn convention. RESULTS: Age and body surface area were found to be highly correlated; but for completeness separate age dependent and body surface area dependent equations for the normal limits of M mode echocardiographic variables were developed. CONCLUSION: A set of age dependent equations and a set of body surface area dependent equations are presented for easy calculation of upper and lower limits of normal M mode echocardiographic variables in infants and children.

Adolescent↗
PubMed1994

Measurement of pressure walking in footwear used in leprosy.

Pressure measurements were made on 10 leprosy patients while walking barefoot and while using 6 sample shoes. The sample shoes, which represented footwear currently used worldwide in leprosy programmes, included: 1, a USA extradepth shoe without insole; 2, a USA extradepth shoe with insole; 3, a Chinese tennis shoe; 4, a Mozambique sandal; 5, a Bombay sandal; 6, a Bombay sandal with rigid sole; and 7, the patients' prescribed footwear. Peak pressure was significantly lower while walking in all footwear, except with the extradepth shoe without an insole, when compared to barefoot walking. Peak pressure was significantly lower walking in the Bombay sandals, the Chinese tennis shoe, the extradepth shoe with an insert and the patients' prescribed shoe when compared to the extradepth shoe without an insert. Regression analysis showed a significant inverse relationship between pressure and insole thickness (P < 0.001, R2 = 0.17).

Biomechanical Phenomena↗